Accountable Care Organization Ralph Edwards Grand Canyon University Operations in Risk Management in Health Care HCA-460 Dr. Smith March 24, 2013 ACO Even although, the cost of the health care system and the care it offers my not allow the national debt to decline to a level that will or would enhance the economy forward the cost of running a system that is backed by the government is too costly, and it will not help the deficit. , the legal responsibility of the organization is that every patron should have the same treatment for the same ailment.
There are no predetermined dispositions; everyone is eligible as a government-backed facility. The funds are to assure those who have no insurance are covered. The accountable care organization needs to sustain a system of health care to the elderly and financially handicap; no one turned away from health care under this system of care. Including but not limited to the handicap and mentally disturbed and during the implementation of the ACA for the elderly, the system allowed all who need care to continue to have health care.
All who live in America have the right and the ability to use the systems health care services for their benefit. The legal responsibility of the ACA has shown itself to be of value to all who depend on this system of care. What is the organization’s legal responsibility? the legal responsibility of the organization is that every patron should have the same treatment for the same ailment. The ACO answerable to a third party payer and the patient for the appropriateness, quality and proficiency of care delivered.
The Centers of Medicaid and Medicare Services (CMS), and the ACO is “health care providers of an organization which approves accountable services of quality, overall care, and quality of Medicare beneficiaries enrolled by the traditional fee-for-service program that are assigned to it. ” Medicare (2010). The cost of running a system that backed by government funds is too costly, and it will not help the deficit. The potential for quality is to reduced, improve and the care while healthcare spending with high expenditures nationwide.
However, the ACO’s have many challenges that affect their implementation for the development of ACO’s. First, lack of specificity on how the ACOs can and will implement. The American Hospital Association estimated the formation of ACOs would create startup cost that is staggering with expenses annually too large to maintain systems, American Hospital Association. (2011). There are three core principles to any ACOs. First, provider-led organizations with primary maintenance and a strong base are liable communally and total per capita costs for quality with full continuum for the population of care for patients.
Second, excellent improvements will have linked to also have complete costs reduced, and third, progressively and reliable sophisticated measurement performance to improve, support, and provide the savings of confidence are achieved with improvements of care, , McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES (2010). The cost of running a system supported by government resources is too costly, and it will not help the deficit. The organizations responsibility for the regulatory practices of the ACO with the best method to improve quality and greater collaboration of care providers that will reduce cost.
Unavoidably, the infrastructure would result with consolidation, coordination in the sector of health care. The Department of Justice and the Federal Trade Commission address the ACOs concerns and developed rules that would regulate their actions over the market power the collude improperly dealing with commercial health plans. This action would not barricade the operation and or formation of the ACOs as Medicare payment reform, McClellan, Mark, et al. (2010). The Advanced Medical Technology Association, which represents MDI, believes that the system may allow the ACOs to emphasis on cost rather than quality of care.
CMS would rather see beneficiary’s stronger oversight, which would require annual consents to ACOs to provide care. “David Nexon, stated that innovation and the process of medical progress is the willingness of the dependent person’s to early medical adopters, which can interrupt that early process of the ACO, senior executive vice president at AdvaMed. In addition, CMS in regards to Medicare should monitor the program. New technology users should not be penalized and the cost should be based on savings and not by any one physician, Jaimy Lee ( June 2011). The overnment will pay the fee for services rendered, traditionally to the ACOs. There is an increase in the cost of health care, experts contend because Medicare programs paid doctors that ordered substantial test for their patients. CMS shall cover expenses incurred for the caring of their patients, one payment received by ACOs. The cost is considered and the extra kept if patients are healthy with prevention methods and managing chronic diseases. Quality assessment benchmarks must be stringent and must include the consequence, experiences, and private process to be suitable (aha. rg, 2012; Gold, 2012). The oversight process of the ACOs had apparatuses, which include but not limited to regulatory environment: Federal Jurisdiction, 3022 of PPACA, and many other oversight processes that administrate the system. The established ACOs outcome is determined, although CMS prays for method used, paved as to return to collegiality patient atmosphere to normality. Therefore, you can see that although the cost of running a system backed by government funds is too costly, and it will not help the deficit.
The legal responsibility of the organization is that every patron has the same treatment for the same ailment, for two main reasons. First, there are no predetermined dispositions everyone is eligible, but most importantly, as a government backed facility the funds that are mandated to assist those who have no insurance are covered. As ACOs becomes more established and maintains the government’s idea and the public’s capacities on health care with reducing cost and heightened quality, balancing the enormous entity will have a profound effect on the public’s outlook of our government directed systems.
The public will undoubtedly respond positively and back the direction of the systems directors and administrators. With the potential of improving quality care and reducing a nations expenditures in health care ACOs still face an abundance of challenges the will affect the ACOs implementation and development. The absence of how the implementation and the AHA estimated and incur startup cost that is sky high The United States Department of Justice. (2011). References Medicare ” Accountable Care Organizations” Shared Savings Program – New Section 1899 of Title XVIII, Preliminary Questions ; Answers”. Centers for Medicare and Medicaid Services. Retrieved January 10, 2010 FTC and the Department of Justice. (2011). “Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program. ” Final Policy Statement, 1-18 American Hospital Association. (2011). “The Work Ahead: Activities and Costs to Develop an Accountable Care Organization. American Hospital Association, 1-17. McClellan, Mark, et al. A National Strategy to put Accountable Care into Practice. Health Affairs. 29(5). 2010. 982-990. Jaimy Lee ( June, 2011) AdvaMed presses for oversight on ACOs | Modern Healthcare http://www. modernhealthcare. com/article/20110608/NEWS/306089961#ixzz2OtSa2rUw The United States Department of Justice. (2011). Department of justice/federal trade commission issue final statement of antitrust policy enforcement regarding accountable care organizations. http://www. justice. gov/opa/pr/2011/October/11-at-1384. html
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